HomeMy WebLinkAbout1983-5120 (Reroof CITY of OIZONO PERMIT Nn � 5120 i
Building Permit -
DATE ISSUED � — ��- � ��
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY EXPIRES
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 � �
ZONING DISTRICT SITE ADDRESS
/ n , / � LEGAL DESCRIPTION: PROP. ID. rS" — // � — � 3 �" -3 l '— U U L�
4 �� LOT BLOCK SUBDIVISION
FIRE ZONE
WNER (Name) (Address) (Phone)
VAR. DATE ���� I � � — ��
ARCHITECT/ENGINEER — Must Certify Multi-Family, Commercial & Industrial Construction Plans
COND. USE DATE ERT.NO.
(�) �� O (Address) � (Phone)
LOT AREA
WIDTH DEPTH BUILDER (Firm) (Address) (Phone)
PROPOSEDSETBACKS
FRONT R.SIDE TYPE OF WORK New Addition Remodel Renovat
R E A R L.S I D E ,/L.Q/1.�1�
CONST. TYPE BLDG. SIZE E T. CONST. VALUATION
LAKE WETLANDS
� �(�
L. W. Ht. 1 �'G�
ACCESS RESIDENTIA STORIES B 1 2 3 PERMIT FEES
BLDG. PERMIT , �J d
NEW EXISTING DWELL. BDRMS/FLR
AGENCY-APPROV. DATE urvlrs STATE FEE , C� (�
CITY GAR.STALLS SEPTIC
ATT. APP. DATE PLAN REVIEW
COUNTY �ET. PENALTY
DOCK
STATE NON-RESID. PROPOSED USE PARK FEE
PR. EASEMENT oCC. SAC CHARGE
C LASS.
STORIES COUNCIL T
APP. DATE TOTAL DUE � � . ��/
REMARKS:
INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT
FOOTING before pour SEPARATE PERMITS
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
FRAMING rough-in
INSULATION PLUMBING THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES
WALLBOARD Before Taping MECHANICAL UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
WELL ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE-
F INA L before occupancy
SEPTIC MENTS REP ESENTED ON THIS DOCUMENT. THE UNDER—
WORK BEYOND OR WITHOUT A RE- SEWER
QUIRED INSPECTION WILL BE SUB- SIGNED FURTH AGREES TO DO ALL WORKS IN STRICT COM-
WATER
JECT TO PENALTY, PLIANCE W TH ALL C Y OF ORONO ORDINANCES AND STATE
GRADING& FILLING
INSPECTION HOURS 473-7357
CALL8 - 12 A.M. INSP. 1 -4 P.M. OF MINNE A B LDING DE REQUIRE ENTS.
CALL 1 - 4 P.M. INSP. NEXT DAY ELECTRICAL from State
Sign Date / �/z ��
COPY: WHITE—FILE GREEN—FINANCE
CANARY—INSPECTOR GOLD—RECEIPT
PINK—ASSESSOR Approved � City of Orono